Coburn Discusses Post-Retirement Plans, Thoughts on Medicare Reform

The Kaiser Daily Health Policy Report sat down this week with Rep. Tom Coburn (R-Okla.) to find out his post-retirement plans. Coburn has been a leader on Capitol Hill on a variety of health issues, including Medicare and Medicaid reform, patients' rights, HIV/AIDS and abortion. Below is a transcript of the interview.
What are your post-retirement plans? Do you intend to return to obstetrics? Public policy? I'll be returning to medicine, obstetrics and family practice ... I'll spend a day a week doing other things, four days a week practicing medicine. ... My practice was and will be again about 80% mamas and their babies. I'll be on several boards, most of them charity boards and things like that that I've wanted to do for a long time. A couple [are] corporate boards, where I'll use my experience prior to becoming a physician to help a couple of businesses ... not in a lobbying context, but in a management context. One's specific to education, one's specific to health care. One of them is a textbook publishing company, Saxon Publishing, and the other one hasn't been announced yet, so I can't give you specifics on what that is.
Is the textbook company specific to health care? For example, will it have a sex education focus? No. What I've seen in children and what I've seen in my experience in education is that we've taught our kids how to memorize, but we haven't taught them how to learn, and we haven't taught them how to reason and think. Saxton publishing is a company that started less than 10 years ago with the concept that you have to build concepts and think and build off those and use them every day so that you eventually learn to reason and think and be able to solve problems, rather than memorize, pass the test and forget it, and can't ever recall it again.
It has been rumored that you are a candidate for HHS secretary in a potential Bush administration. Is this a position you would consider if offered? Nobody knows what that is, it's all pure speculation and hype and there's no reason to consider because it's not ...
If offered, though, would you take it? It's all contingency. It would depend on what the position would be, what the dedication of the principles behind it are. The one thing I don't want to do is be a part of any team that doesn't have a plan, or is afraid to lose for what they believe, and that's what, for me, has been a hallmark of the Republican Congress ... They haven't been willing to lose on the principles ... they compromise before they ever get there. And it's okay to lose. We learn from our losses. When we fail to take something with a position of loss, you don't define the issue [and] the issue never comes to [the] public. ... There's a lot of integrity in standing for a principle that you believe to be correct, even if you're in the minority. It's okay to lose, and in Washington, that's a foreign concept. So anything that I would do in a [Bush] administration would depend on, number one, position, and what the backing would be for what the goals were. ... I really don't seriously think that I would be under consideration for something like that, simply because of my reputation in the House.
What do you consider your most important contribution during your congressional career? Health care's my favorite, but my best contribution has probably been being a voice for reason on spending. We really have made some great contributions in terms of restraint ... The bias in Congress is so pro-spending, simply because of the political nature of the body ... that we seem to forget about the future and the future is our children and our grandchildren. And what we do now makes a tremendous impact on the living standards that our children and grandchildren are going to see. ... Health care is a great area where we're going to suffer dramatically, and we already are today. In both Medicaid and Medicare, the nation is suffering, not because those aren't things that we should do, it's because they've been tremendously underfunded, and therefore the society's been taxed twice: They've been taxed through payroll taxes ... and then they've been taxed in the cost of their health care outside of those finances because they're subsidizing, through increased premiums, the Medicare and Medicaid programs.
Would this be the one issue that could, hypothetically keep you in office? I never had any intent to serve more than six years, so there isn't anything that could keep me in office. There is no question that if the next Congress doesn't tackle this issue, the costs are going to skyrocket even more. We need to [redesign] the public health care program to incentivize people to do the right thing, not the wrong thing. Doctors and health care providers aren't stupid people. They can get around any gimmick system that the government sets up, if greed is the number one [motivation]. So what you ought to do is ... use that innate personal trait in every human being ... for something positive for patients, rather than something negative. I think there is so much that can be done with Medicare and Medicaid to streamline it and make it more efficient and make it available to those that truly need it. Right now in many of the states, we have people getting obstetric care and pediatric care when their parents make $45-50,000 a year. They're dropping their health insurance and going on the government's plan ... that's the big shift towards national health care, and we're seeing it, incrementally, take place (Ingrid Dries-Daffner, Kaiser Daily Health Policy Report, 12/5).